scholarly journals Neonatal near misses and associated factors among mother’s who give a live neonate at Hawassa City governmental hospitals, 2019: a facility based cross-sectional study design

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anteneh Fikrie Tekola ◽  
Genet Baye ◽  
Elias Amaje ◽  
Kebede Tefera

Abstract Background Neonatal near miss is a neonate who nearly died but survived from a severe complication occurred during pregnancy, birth or within 0–28 days of extra-uterine life. However, there is no available data that quantifies the magnitude of neonatal near miss (NNM) in Ethiopia where there is high prevalence of neonatal mortality. Therefore, this study is designed to provide information about the magnitude and associated factors of neonatal near miss among women who give a live birth at Hawassa City Governmental hospitals, 2019. Methods A facility based cross-sectional study design was conducted on 604 mothers who gave live neonates at Adare General Hospital and Hawassa University Comprehensive and Specialized Hospital from May 9, 2019 to June 7, 2019. Face to face interviewer administered structured questionnaire with a supplementation of maternal and neonatal medical records with checklists were used to collect the data. Data were coded and entered in to Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. Descriptive statistics was run and the data were presented using frequency tables and figure. The bi-variable and multivariable logistic regression was used to identify the possible factors of neonatal near miss. Finally, Adjusted Odds Ratio and 95% Confidence Intervals were used to declare statsticall significance. Result Among all 604 selected live births an overall proportion of NNM cases, 202 (33.4%) (95% CI: 29.7–37.1%) was obtained at Hawassa City Government Hospitals. Respiratory distress 158 (94%) and infection or sepsis 138 (84%) were found to be the leading causes of NNM cases in our study. Governmental and non-governmental employed mother (AOR = 3.05, 95% CI: 1.46–6.44) and Cesarean Section delivery (AOR = 1.89, (95% CI: 1.25–2.83)) were positively significantly associated with neonatal near miss. Whereas, pregnancy induced Hypertension (AOR = 0.43, 95%CI: 0.27–0.69) was negatively associated with neonatal near miss. Conclusion This study revealed relatively high prevalence of NNM in the study areas. Employed women, pregnancy induced hypertension and cesarean section mode of delivery were found to be independent factors affecting the prevalence of NNM cases. Therefore, HUCSH and Adare general Hospitals should focus on proving quality antenatal care and prevention of occupational related problems among pregnant women.

2020 ◽  
Author(s):  
Anteneh Tekola Fikrie ◽  
Genet Ake Baye ◽  
Elias Hadona Amaje ◽  
Kebede Tefera

Abstract Background: Neonatal near miss is a neonate who nearly died but survived from a severe complication occurred during pregnancy, birth or within 0-28 days of extra-uterine life. However, there is no available data that quantifies the magnitude of neonatal near miss in Ethiopia where there is high prevalence of neonatal mortality. Therefore, this study is designed to provide information about the magnitude and associated factors of neonatal near miss among women who give a live birth at Hawassa City Governmental hospitals, 2019. Methods: A facility based cross-sectional study design was conducted on 604 mothers who gave live neonates at Adare General Hospital and Hawassa University Comprehensive and Specialized Hospital from May 9, 2019 to June 7, 2019. Face to face interviewer administered structured questionnaire with a supplementation of maternal and neonatal medical records with checklists were used to collect the data. Data were coded and entered in to Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. Descriptive statistics was run and the data were presented using frequency tables and figure. The bi-variable and multivariable logistic regression was used to identify the possible factors of neonatal near miss. Finally, Adjusted Odds Ratio and 95% Confidence Intervals were used to declare statsticall significance. Result Among all 604 selected live births an overall proportion of Neonatal Near Misses (NNM) cases, 202 (33.4 %;) (95% CI: 29.7%-37.1%) was obtained. Respiratory distress 158 (94%) and infection or sepsis 138 (84%) were found to be the leading causes of NNM cases in our study. Employed (AOR = 3.05, 95% CI: 1.46- 6.44), Pregnancy induced Hypertension (AOR = 0.43, 95%CI: 0.27-0.69) and Cesarean Section (AOR=0.49; 95%CI: 0.33-0.71) were significantly associated with neonatal near miss. Conclusion: This study revealed relatively high prevalence of neonatal near miss in the study areas. Employed women, pregnancy induced hypertension and cesarean section mode of delivery were found to be independent factors affecting the prevalence of NNM cases. Therefore, HUCSH and Adare general Hospitals should focus on proving quality antenatal care and prevention of occupational related problems among pregnant women.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251609
Author(s):  
Merertu Wondimu ◽  
Fikadu Balcha ◽  
Girma Bacha ◽  
Aklilu Habte

Background Neonates with severe complications at birth or during the neonatal period who nearly died but survived constitute neonatal near miss (NNM) cases. Identifying NNM cases and correcting contributing factors are of the utmost importance to get relevant controls for neonatal deaths. However, limited studies are assessing the prevalence of NNM and associated factors with NNM cases in Ethiopia. So, this study is aimed at assessing the magnitude of neonatal near miss and associated factors among live births in public hospitals of Jimma zone, southwest Ethiopia, 2020. Methods A facility-based cross-sectional study was conducted among 260 neonates from April 1–30 / 2020. Face to face interviewer-administered structured questionnaire was used to collect data from the mothers and a standard checklist was used for their neonates. The data was encoded and entered into Epi-Data version 4.2 and exported to SPSS version 23 for analysis. Independent variables with marginal associations (p-value <0.25) in the bivariable analysis were eligible for multivariable logistic regression analysis to detect an association with outcome variables. Finally, adjusted odds ratios (AOR) with 95% CI were used to estimate the strength of associations, and statistical significance was declared at a p-value < 0.05. Result The magnitude of NNM was 26.7% with [95%CI: 21.6–32.5]. Hypertension during pregnancy [AOR: 3.4; 95%CI: 1.32–8.88], mode of delivery [AOR: 3.32; 95%CI: 1.48–7.45], Obstructed labor [AOR: 2.95; 95%CI: 1.32–6.45] and non-vertex fetal presentation during delivery [AOR: 4.61; 95%CI: 2.16–9.84] were identified as significantly predictors of NNM. Conclusion and recommendation Over a quarter of the neonates were with NNM cases, which is relatively higher than the report of studies done in other countries. Hypertension during pregnancy, cesarean delivery, prolonged labor, and non-vertex fetal presentation were all found to increase the likelihood of NNM. Therefore, concerted efforts are needed from local health planners and health care providers to improve maternal health care services especially in early identification of the complications and taking appropriate management.


2021 ◽  
Author(s):  
Andualem Mebratu ◽  
Dawit Getachew Assefa ◽  
Eden Dagnachew Zeleke ◽  
Wondwosen Molla ◽  
Nebiyu Mengistu ◽  
...  

Abstract Introduction: Induction of labour is one component of comprehensive obstetrics care services that is increasing employed in modern day obstetrics to decrease the risk of maternal and neonatal morbidity and mortality. However, it has been strongly associated with poor maternal and perinatal outcomes. Therefore, his study was aimed to assess the magnitude of failed induction of labour and associated factors among mothers delivered at Jigjiga University Sheik Hassan Yabare referral Hospital, Eastern Ethiopia from June 1 to June 30, 2021.Methods: An institutional based cross-sectional study was carried out among 364 women’s delivered at Jigjiga University Sheik Hassan Yabare Referral Hospital from 2018 to 2021. A checklist was used to collect the data from the women’s chart. To isolate independent predictors related to failed induction of labour, multivariate logistic regression analyses were performed.Result: Our study participants were 364 women’s. The magnitude of failed induction of labour was 36.8% (95% CI: 31.8, 42.0). Age of the mother (<30 years) (AOR= 3.2; CI: 1.78, 5.75), rural residency (AOR=2.28; CI:1.29, 4.01), being primi-para (AOR= 2.76; CI: 1.55, 4.91), gestational age less than 37 or greater than 42 year (AOR= 2.65; CI: 1.44, 4.89) , multiple ton of pregnancy (AOR= 2.36; CI: 1.01, 5.55), premature rapture of membrane (AOR= 4.88; CI: 2.33, 10.21), pregnancy induced hypertension (AOR= 5.11; CI: 2.67, 9.79), and bishop score less than six (AOR= 1.95; CI: 1.15, 3.32) were significantly associated with failed induction of labour.Conclusion: The magnitude of failed induction of labour among mothers undergoing labor induction was relatively high in the study settings compared with previous studies in the country. Failed induction of labour was significantly associated with age of the mother (<30 years), rural residency, being primi-para, gestational age less than 37 or greater than 42 years, multiple ton of pregnancy, premature rapture of membrane, pregnancy induced hypertension, and bishop score less than six.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rajbanshi Sushma ◽  
Mohd Noor Norhayati ◽  
Nik Hussain Nik Hazlina

Abstract Background The rate of neonatal mortality has declined but lesser than the infant mortality rate and remains a major public health challenge in low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 h after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods A hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and gestational age were enrolled. Key inclusion criteria were pragmatic and management markers of NNM and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0. Results One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI) 2.07–9.84) and no formal education (aOR 2.16; 95% CI 1.12–4.14) had a positive association with NNM, while multiparity (aOR 0.52; 95% CI 0.32–0.86) and caesarean section (aOR 0.44; 95% CI 0.19–0.99) had negative associations with NNM. Conclusions Maternal characteristics and complications were associated with NNM. Healthcare providers should be aware of the impact of obstetric factors on newborn health and provide earlier interventions to pregnant women, thus increasing survival chances of newborns.


2021 ◽  
Author(s):  
Sushma Rajbanshi ◽  
Norhayati Mohd Noor ◽  
Nik Hazlina Nik Hussain

Abstract Background: Unlike the infant mortality rate, the rate of neonatal mortality has not significantly declined and remains a major health challenge in the low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods: A hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and number of gestational weeks were enrolled. The key inclusion criterion was the pragmatic and management markers of NNM, and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0.Results: One thousand respondents were recruited. Prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI): 2.07–9.84), no education (aOR 2.16; 95% CI 1.12–4.14), multiparity (aOR 0.52; 95% CI 0.32–0.86), and caesarean section (aOR 0.44: 95% CI 0.19–0.99) were associated with NNM. Conclusions: Prevalence of NNM in Nepal was 7.9%. Mothers’ obstetric factors, maternal complications and education were associated with NNM. Women in referral hospitals should have safer access to caesarean section and be prepared for NICU intervention to save mothers and their newborns.


2020 ◽  
Author(s):  
Sushma Rajbanshi ◽  
Norhayati Mohd Noor ◽  
Nik Hazlina Nik Hussain

Abstract Background: Unlike the infant mortality rate, the rate of neonatal mortality has not declined and remains a major health challenge in the low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than the neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods: A hospital-based cross-sectional study was conducted at Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and number of gestational weeks were enrolled. The key inclusion criterion was the pragmatic and management markers of NNM, and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression analysis was performed using SPSS® version 24.0.Results: One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (AOR): 4.51, 95% confidence interval (CI): 2.07–9.84), maternal secondary (AOR: 0.46, 95% CI: 0.24–0.88) and tertiary education (AOR: 0.18, 95% CI: 0.05–0.56), multiparity (AOR: 0.52, 95% CI: 0.39–0.86), and caesarean section (AOR: 0.48, 95% CI: 0.19–0.99) were associated with NNM. Conclusions: The prevalence of NNM in Nepal was 7.9%. Mothers’ obstetric factors, maternal complications and education were associated with NNM. Referral hospitals should have safer access to caesarean section and be prepared to offer NICU intervention to save mothers and their newborns.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Mengstu Melkamu Asaye

Background. Life-threatening situations might arise unexpectedly during pregnancy. Maternal near-miss can be a proxy for maternal death and explained as women who nearly died due to obstetric-related complications. It is recognized as the predictor of level of care and maternal death. Maternal near-miss evaluates life-threatening pregnancy-related complications, and it directs the assessment of the quality of obstetric care. Objective. To determine the proportion and factors associated with maternal near-miss at maternity wards at the University of Gondar Referral Hospital, Northwest Ethiopia, 2019. Methods. A cross-sectional study design was carried out from March 1 to June 20, 2019, using WHO criteria for maternal near-miss at the University of Gondar Referral Hospital. The data are from the interviews and review of 303 systematically selected participants’ medical files at maternity wards. Bivariate and multivariable logistic regression analyses were performed to analyze factors associated with maternal near-miss, including estimation of crude and adjusted odds ratios and their respective 95% confidence intervals and p value less than 0.05 through SPSS version 20. Result. The study revealed that the proportion of maternal near-miss was found to be 15.8% (95%CI=11.9%-20.1%). In the adjusted analyses, maternal near-miss was significantly associated with low (≤1000 ETB) monthly income (AOR=399; 95%CI=1.65, 9.65), seven or more days of hospital stay (AOR=5.43; 95%CI=2.49, 11.83), vaginal bleeding (AOR=2.75, 95%CI=1.17, 6.47), and pregnancy-induced hypertension (AOR=5.13; 95%CI=2.08, 12.6). Conclusion and Recommendation. The near-miss proportion was comparable to that in the region. Associated factors were low monthly income, seven or more days of hospital stay, vaginal bleeding, and pregnancy-induced hypertension. Thus, giving attention on early identification and treatment of these potential factors can be the opportunity in the reduction of maternal morbidity and mortality.


2020 ◽  
Author(s):  
Sushma Rajbanshi ◽  
Norhayati Mohd Noor ◽  
Nik Hazlina Nik Hussain

Abstract Background: Unlike the infant mortality rate, the rate of neonatal mortality has not declined and remains a major health challenge in low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours of birth and the early neonatal period. Determining which factors contribute to neonatal near miss (NNM) can be used to assess health care quality and identify factors capable of correction in the healthcare system to improve neonatal care. Thus, the objective of the current study was to establish the prevalence of NNM and identify its associated factors.Methods: A hospital-based cross-sectional study was conducted at Koshi Hospital, Nepal. Neonates and their mothers (unspecified maternal age and number of gestational weeks) were enrolled. The key inclusion criterion was the admission of newborn infants to the neonatal intensive care unit at Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size (i.e., 1,000 newborn infants) was reached. Simple and multiple logistic regression analysis was performed using SPSS ® version 24.0.Results: One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Maternal secondary (adjusted odds ratio (AOR]: 0.46, 95% confidence interval (CI]: 0.24–0.88) and tertiary education (AOR: 0.18, 95% CI: 0.05–0.56), multiparity (AOR: 0.52, 95% CI: 0.39–0.86), Caesarean section (AOR: 0.48, 95% CI: 0.19–0.99), and severe maternal morbidity (AOR: 4.51, 95% CI: 2.07–9.84) were significantly associated with NNM.Conclusions: Parity, severe maternal morbidity, mode of delivery, and maternal education were significantly associated with NNM. Healthcare workers should be aware of the impact of obstetric factors so that earlier interventions, especially the Caesarean section, can be exercised.


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